Organization
TENNET LLC
Active
Other names
Prime Time Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID R SPRAYBERRY MD (CEO)
(706) 705-4543
Entity
Organization
Contact information
Practice address
1618 MARS HILL RD STE B, WATKINSVILLE, GA 30677-4847
(706) 705-4543
Mailing address
1618 MARS HILL RD STE B, WATKINSVILLE, GA 30677-4847
(706) 705-4543
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447275805
NPI
—
Enumeration date
11/22/2019
Last updated
11/22/2019
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